IOWA, USA — Thousands of Iowans may have temporarily lost Medicaid or coverage through the Children's Health Insurance Program (CHIP) due to a system issue related to automatic renewals, according to a letter from the Centers for Medicare and Medicaid Services (CMS).
Those Iowans would be just a fraction of the 500,000 Medicaid recipients nationwide who recently lost coverage due to state system failures.
During the COVID-19 public health emergency, Iowans who qualified for Medicaid were able to stay in the program regardless of their income. However, once the moratorium ended, the state of Iowa began conducting Medicaid eligibility reviews to determine whether or not individuals still qualified.
Eligibility reviews often begin with a computer program to determine if one can be automatically reenrolled. If that doesn't work, individuals are sent renewal notices asking for more information.
Eligibility should be reviewed for each individual rather than at the household level, as different people living in a household might have different eligibility statuses and income thresholds.
In a letter dated Aug. 30, CMS reminded state Medicaid directors to comply with the above guidelines in order to avoid potential system issues. However, the most recent letter indicates that as of Sept. 21, 30 states and territories—including Iowa—are still not conducting automatic renewals at the individual level. The discrepancy is what likely led to the lapse in coverage.
Between 10,000 and 49,999 individuals in Iowa are estimated to be affected by the Medicaid and/or CHIP lapses. CMS has yet to determine which populations have been most affected.
As of May 2023, a total of 858,044 individuals were enrolled in Medicaid and CHIP, with 388,893 of those being children.
"CMS will be reviewing all the information provided by states and offering direct assistance as states work to complete their assessments and achieve compliance," the CMS letter says.
Local 5 has reached out to the Iowa Department of Health and Human Services for comment and will update this story with any response.